Sometimes living with Hashimoto’s is like being on a ride at a dark amusement park.
You get better, you get worse, you get flare ups: aches & pains, mood swings, you forget and just want to lay down.
It all seems random.
Start keeping a journal and you will start to see the things that take you for a ride.
What should you look for?
One of the most important things for you to learn to identify are your “triggers”. Triggers are the things that cause an immune reaction.
This immune reaction ends up triggering a more aggressive autoimmune response which means inflammation and tissue destruction.
These “triggers” cause “flare ups” or a worsening of your symptoms. One of the best ways to find your triggers is by observation.
Note the foods you eat, note the experiences you have especially those that are very stressful or emotionally draining.
Note what chemical toxins you are exposed to: cleaning products like bleach, cigarette smoke, formaldehyde, exhaust, etc.
Another thing that is really important to understand about Hashimoto’s is that how you feel is diagnostically relevant and clinically significant.
Somehow, inexplicably, many doctors have forgotten that one of best tools of diagnosis and treatment is clinical observation.
For some reason with Hashimoto’s and hypothyroidism this has been erased from their brains and the only relevant finding has become TSH and, if you’re lucky T4 blood test results.
There are about a dozen reasons why TSH and T4 testing is unreliable at best and clinically useless at worst. Check out this post to learn more about this sorry state of affairs.
Really, being a good doctor is a lot like being a good detective.
And in today’s conventional medical model you’re pretty much on your own when it comes to figuring out your Hashimoto’s.
So, don’t rely on anyone else.
Keep a journal, be your own detective. Identify your triggers and eliminate them.
Then your life will stop being such a dark amusement park ride.
Today’s health tip concerns the relationship between your adrenals and thyroid health.
Remember the body is an ecosystem with many systems interacting all the time. One example of this is the adrenal glands and how they impact thyroid hormone absorption.
Chronic immune stimulation, like Hashimoto’s, sets the stage for high cortisol for a prolonged period of time.
This chronic adrenal stress can:
* Increase thyroid binding proteins, so that thyroid hormones can’t get into cells to do their job.
With more thyroid binding proteins, you have less free and available thyroid hormone. It’s like going to a dance, if all the available boys or girls are with dates, your chances of getting some are a lot lower.
* Mess up detoxification pathways, which can lead to thyroid hormone resistance.
If your liver isn’t detoxing properly, thyroid hormone can’t get converted from T4 into it’s active form T3. It’s like driving on the freeway, if there’s lots of traffic, you ain’t goin’ nowhere.
* Slow the conversion of T4 to active forms of T3 that the body can use.
This happens in the liver, it also happens in the digestive tract where the whole process is helped along by good bacteria and in the peripheral tissue. High cortisol leads to problems in the first 2 areas. Eventually, you empty your cortisol tank and then you get problems in the third.
* Weaken the barrier system defenses of the digestive system, the lungs and the brain.
High cortisol leads to imbalances in the gut and intestinal permeability. It’s like your alarm system breaks down and all manner of riff raff just come on in.
This can trigger Hashimoto’s or cause flare ups or both.
Heal your adrenals by:
Balancing your blood sugar: Read all about it in this previous post.
Healing your adrenals: Read all about this in this other previous post.
And relax, people! It’s all going to be fine. Really, it is! 🙂
I have a confession to make. I tend to be rather obsessive. Lately, I’ve been obsessing about how to make affirmations work if you suffer from low self esteem.
Let’s face it, Hashimoto’s can definitely impact your self-esteem because it can affect the way you look and feel and it can deplete you of the energy to do something about it.
I think the issue here may be one of believing what you say to yourself. Sometimes, we say an affirmation and we believe it and it resonates. Other times we say something and a louder inner voice shouts it down and tells you its not true or its a bunch of baloney (not my first choice of words).
So, I pondered obsessively, how can we use some internal tai chi move to quiet that inner voice and get ourselves to believe the affirmation long enough to make it work?
EFT. EFT or Emotional Freedom Technique can be a powerful tool to get the negative emotions out of your body even if that inner voice is drowning out the good stuff. EFT uses acupuncture points to help you access emotions held in your body.
Dr. Candace Pert is a researcher and really smart person who wrote a great book called Molecules of Emotion that explores that mind-body connection. For me the book was basically saying that the body is the subconscious mind. Your emotions get buried in your cells.
You can use EFT to unbury them. There is a place you can tap right below your pinky finger on either hand.If you trace the outside of your pinky down to the bottom, there is a bone there. Continue down to the bottom of that and there is a tender spot. It’s where you might do a karate chop.
In this photo, I permanently disfigured myself with a Sharpie to show you the exact spot.
You can say an affirmation like “I deeply and completely love and accept myself” or “I completely forgive myself” while you are tapping this point.
As you do it check in with your inner voice, if you here the screams from the inner peanut gallery, don’t fight them.
Acknowledge them, and say “Even though I think this is total crap ( or whatever word comes to mind), I deeply and completely love and accept myself.” or words that resonate for you.
And observe how you feel. Often with repetition and determination, you can take the sting out of that negative self talk and start to replace those neural pathways with more positive self talk that you start to believe.
Social psychologist, Amy Cuddy, explains in this TED Talk how to use physical postures to change the way you feel about yourself, as well as how others feel about you.
By spending just two minutes “power posing” with their arms or elbows out, their chin lifted and their posture expansive. (Think Superman or Wonder Woman).
Cuddy’s research, done in collaboration with Dana Carney, has shown that adopting the body language associated with dominance for just 120 seconds is enough to create a 20 percent increase in testosterone and a 25 percent decrease in the stress hormone cortisol.
In other words, adopting these postures makes a person feel more powerful.
It also makes you feel more positive and happy. Do it with a smile and see what I mean!
Another positive pose is the “victory pose” that most athletes do naturally. Arms raised above your head in a “V”, legs spread wide.
I’m doing them all day long! What makes you feel more powerless than Hashimoto’s?
No longer, people!
To learn more, check out this article:http://www.huffingtonpost.com/amy-cuddy/body-language_b_2451277.html
Please share your obsessive insights about making positive changes in your life.
Today’s health tip concerns blood tests.
As I’m sure many of you have experienced, most doctors and even some alternative care practitioners rely heavily on test results.
The most commonly ordered are TSH and T4. Some doctors won’t order anything other than TSH. And many labs now do what is called a TSH cascade, which means they only test more than TSH if TSH is out of range.
Which it isn’t, a lot of the time. Regardless of how lousy you feel.
Lately, several people have posted questions regarding their lab values.
In most cases, I can’t give a good answer.
I’m not trying to be a jerk, it’s because lab tests are flawed. They are not the be all and end all.
They do not provide answers by themselves.
With Hashimoto’s, what you feel, the symptoms you have, are clinically significant and diagnostically important.
And here’s why this is especially true of TSH.
TSH is thyroid stimulating hormone. It is released by the pituitary gland to signal the thyroid to release thyroid hormone.
And research has found that the pituitary does not absorb thyroid hormone in the same way that the rest of the cells in the body do.
A recent study published by the European Thyroid Association looked into the question of whether or not TSH and the amount of thyroid hormone in the cells of the body were directly correlated and why T4 was sometimes poorly absorbed.
Another study from the British Medical Journal showed that TSH levels had no correlation with tissue thyroid levels and could not be used to determine a proper or optimal thyroid replacement dose.
The authors concluded that “TSH is a poor measure for estimating the clinical and metabolic severity of primary overt thyroid failure. … We found no correlations between the different parameters of target tissues and serum TSH.”
Do want to know what your test results mean? Look at them in the context of how you feel. A thorough assessment of your signs and symptoms is, by far, the best way to understand how you feel.
Trust your body. It will tell you whether or not what you are doing is working.
“Good morning, Pooh Bear,” said Eeyore gloomily.
“If it is a good morning,” he said.
“Which I doubt,” said he.
“Why, what’s the matter?”
“Nothing, Pooh Bear, nothing.
We can’t all, and some of us don’t.
That’s all there is to it.”
“Can’t all what?” said Pooh, rubbing his nose.
Here we go round the mulberry bush.”
Do you ever feel like Eyeore? Having Hashimoto’s can make you doubt that it is a good morning. Sometimes I feel that way.
But lately, I’ve been thinking how it’s important not to take things so seriously. You have to have a sense of humor about it all.
Last time I posted an affirmation, it was pointed out that studies have shown that affirmations only work on people with high enough self-esteem.
If you are like Eyeore and don’t think too highly of yourself then you are doomed. Affirmations will make you even more depressed.
I have to say that made me laugh, but at the same time I recognized the truth in it. You can’t just slap on an affirmation, you have to do the inner work too.
Whatever your take on this, remember to have a sense of humor.
When you can laugh at yourself or at the situation you are in it can take the sting out of it.
Here’s a funny example. I recently rescued a dog from the pound. He’s a beautiful 3 year old fox terrier. Boy have they got a lot of energy!
Well, I wanted to rescue him so I’d be motivated to get off my butt more. That worked. But, he had so much energy I was a bit overwhelmed.
So I watched about 10 episodes of the Dog Whisperer. And the techniques I learned actually started to work.
But, he wasn’t in the pound for no reason. He sometimes bites when he freaks out. He bit my hand, then a couple of days later he bit my foot.
Here I am thinking, “I’m the new Dog Whisperer” and meanwhile, every time I come out of the house I’ve got a new part of my body bandaged and I’m limping and grimacing.
It was a pretty hilarious thing to see.
I was able to see the humor in it and I and my family really had a good laugh over it. In fact, I called my mother to share the story with her and she was in hysterics for a good 5 minutes.
And actually, we stuck with him and he’s calmed down an incredible amount. He’s a wonderful dog!
Life is so much more enjoyable if you can find a way to laugh about what you are going through. Ultimately, you do have a choice.
As a good friend of mine says,
“Have a great day! Unless you have other plans.”
Today’s health tip concerns how to wrap your mind around the complexity of this disease and why half measures usually don’t work.
One of the things I often encounter in working with people with Hashimoto’s is that they have tried this or that and been prescribed this or that and they have arrived right back at zero.
There are many reasons for this, but if you look at the big picture, one of the main ones is that what they have tried has simply not been enough.
It has not been nearly enough.
In order to understand how this all works, you really need to view this globally. There is usually no single drug or single supplement that is going to just make everything perfect again.
This is a multi-system disorder and the only way to properly deal with it is to have a multi-system strategy.
The unfortunate thing is that we are all conditioned by our current medial model which says that this pill or even that natural supplement should be prescribed when you have this group of symptoms.
Well, often with Hashimoto’s you have a web of things overlapping causing a vicious cycle of symptoms that don’t only have one cause. They have multiple causes. And sometimes, things are moving in multiple directions at the same time.
The result is a downward spiral that can seem overwhelming and endless. Blood sugar issues and adrenal problems lead to thyroid problems which lead to intestinal problems which lead to brain problems which lead back to more thyroid and adrenal problems. And on and on…..
Well, the good news is that if you can wrap your mind around this big picture concept and you devote the time ,energy and effort to make enough changes and do enough, then you can turn these downward spirals on their head.
They become positive upward spirals of healing because all these connections can work in a positive direction as well.
Once you start healing these various pieces they start healing each other.
You just can’t do it in a half hearted way.
Half measures don’t give you half results, they often give you no results.
It occurred to me today that if we are going to heal, we need to have a vision. A healing intention of where we want to be.
So often, we are focused on not being healthy or this unpleasant symptom or that. Or everything we have lost. Or the science of blah, blah, blah.
Well, what would you like? Let’s brainstorm on what healing your Hashimoto’s looks like, feels like and is.
Answer these questions:
1. What would you like? (Try to answer in the affirmative: for example: abundant energy, beautiful full hair, mental clarity and focus, happiness, joy, days on end without pain, being my perfect weight, etc.)
2. How would it feel in your body? (Absolutely awesome! I would feel joy and peace, deep inner happiness, love for myself and everyone else, etc.)
3. What will feeling that way do for you? (Allow me to have my life back, let me spend more time with my kids and my family and friends, restore my lust for life, help me have fun again, etc.)
4. How will you know when you have it? (Be specific.)
5. What might stop you from getting there? (Is that your belief or someone else’s?)
Write down your answers and read them every morning. This can help to rewire your brain. This is your vision, your intention, the place you want to be. And be aware, number 5 may be something you need to work on…..
Our bodies are not machines. They are groups of ecosystems all interacting with each other. And just like the health of ecosystems on our planet, problems in one ecosystem can cause a ripple effect and cause problems in other areas.
This is especially true with the ecosystem of the digestive tract and thyroid health. Our digestive system is teeming with life.
There are billions and billions of bacteria from many different species all living there. Many of them do important jobs for our bodies.
One of the jobs that they do is to help convert thyroid hormone from its inactive form T4 into a form that the body’s cells can actually use, T3.
This is a really good thing.
Unfortunately, people often don’t pay enough attention to maintaining a healthy ecosystem in their digestive tract. This is true of doctors and patients.
Many things can lead to the death of good bacterial species and the overgrowth of ones that aren’t so helpful.
Antibiotics, processed foods, too much sugar, antacids, NSAIDS and environmental toxins are just a few things that can turn that digestive garden of eden into a post industrial waste land.
When this happens, thyroid hormone doesn’t get converted as well.
Bacterial gut infections can reduce thyroid hormone levels, dull thyroid hormone receptor sites, increase reverse T3, decrease TSH and promote autoimmune disease.
With Hashimoto’s, a particularly nasty species of bacteria called Yersinia enteroclitica has been found to be 14 times higher in some people with the disease.
Bottom line: Having a healthy ecosystem in your gut is very important for helping your thyroid work properly. It is also important for helping thyroid replacement hormone work properly.
All of which matters because if your thyroid doesn’t work properly and thyroid hormone doesn’t work properly then you feel like crap.
And you have all the symptoms of hypothyroidism: fatigue, weight gain, depression, hair loss, pain, constipation, brain fog, mental sluggishness and the unending desire to read posts from Hashimoto’s Healing to figure out what is actually going on. 🙂
Today’s Hashimoment concerns learning that someone close to you has the disease.
There definitely is a genetic component to Hashimoto’s and sometimes its harder to hear that a family member has been diagnosed than learning about it yourself.
Recently, a close family member was diagnosed with this and I have to say it seems to have hit me harder than my own diagnosis.
Sometimes, it’s easier to get news like that for yourself than for someone you love. I don’t know why exactly, but maybe it comes from wanting to protect them and save them from suffering.
I feel like I can handle most anything, but when I see someone else is hurt by this disease I feel a little more powerless and a little more defensive.
It can really make me angry and want to lash out. But who do you lash out at?
I’ve been mad at God, mad at fate and mad at the universe. Wondered why, wondered if I had failed to do something I should have.
I don’t want them to go through it. I’d much rather it were just my burden. The good news is we have each other and we have all the accumulated wisdom and experience of dealing with this to bring to bear and to share.
But, I sure wish it was something I could have prevented instead.
Of course, hindsight is 20/20. If I knew several years ago what I know now, I would have done a number of things differently. But I wouldn’t know what I know now if I hadn’t gone through all of this.
We all have our journeys and we all have to go through what we go through. I’m grateful we have each other.
I’d love to hear your thoughts on this, people. Please comment below.
Several of the most common symptoms of Hashimoto’s are brain related. Some of these are obvious such as brain fog and memory loss, others are less so, like depression and neurological disorders which can resemble or develop into Alzheimer’s and Parkinson’s disease.
Regardless of how obvious they are, all these brain related symptoms are a sign of degeneration of the brain. This is not a good thing.
In this post we will look at how Hashimoto’s impacts the brain and why you really need to take it seriously before it’s too late.
In fact, it’s never too early to start working on this. Thyroid health and brain health are linked from our earliest development in the womb.
One of the truths that, unfortunately, gets little attention is the impact of a healthy thyroid on the development of a healthy baby, especially a developing baby’s brain.
If you have Hashimoto’s and you want to get pregnant it is very important for you to test your thyroid early and often.
There is a very real risk of retardation or poor brain development and studies have shown that women who are hypothyroid during pregnancy are 4 times more likely to have a child with autism.
And it is important to realize that if you are taking thyroid replacement hormone that you may need to have your doctor adjust your dosage in order to ensure that your baby’s brain develops properly.
For more information on this check out my earlier post on Pregnancy and Hashimoto’s.
These risks are not only present in the developing brain of a fetus. Once a child is born, if they have too little thyroid hormone, they can experience issues with learning language and have memory problems.
This may be caused by a number of factors. Some environmental toxins have been shown to negatively impact thyroid hormone production. In fact, studies have shown that polychlorinated biphenyls alter the expression of thyroid hormone-responsive genes in children’s brains.
In adults, thyroid hormone has been shown to have major influences over virtually every brain activity. T3 and T4 are involved in the neurogenesis, neuronal migration, axonal and dendritic growth, mylenation and more.
Hashimoto’s and hypothyroidism can lead to various disorders including lethargy, hyporeflexia and poor motor coordination. They are also linked to bipolar affective disorders, depression, or loss of cognitive functions, especially in the elderly.
And in the most extreme cases, Hashimoto’s can lead to a condition called Hashimoto’s Encephalopathy which can cause severe changes in the brain that look very much like the destruction caused by Alzheimer’s.
Clearly, thyroid hormone has a powerful effect on the brain. And hypothyroidism and brain inflammation can cause serious and lasting damage to the brain.
One of the most common symptoms of Hashimoto’s is brain fog, that feeling like you are thinking through a haze, like you can’t quite focus or concentrate no matter how hard you try.
Brain fog is an indication of inflammation in your brain. Immune cells in the brain, called microglia are responsible for this.
The immune system in the brain is different than the immune system in the rest of the body. In the body it is much more complex, there are many different parts and they balance and regulate each other.
In your brain, the immune system is simpler. It’s like one of those people that has only 2 speeds, sleeping or balls to the wall.
Microglial cells have an extremely hair trigger. And they are capable of inflicting major damage. (Think chihuahua with an automatic rifle.) Frighten them or make them mad and there’s carnage, everywhere.
These cells are responsible for causing Alzheimer’s, Parkinson’s, cardiovascular disease and more.
These cells also respond quickly to pathogens and injury, accumulate in regions of degeneration and produce a wide variety of pro-inflammatory molecules. That’s right, they cause inflammation.
Thyroid hormone has a major influence on them. It can help keep them calm and modulate them. This is why some people with Hashimoto’s notice that their brain fog really improves once they are given thyroid hormone.
For many others, this doesn’t help at all. If this is the case, there is something else driving the inflammation and the immune attack. (More on this in a moment.)
Another common symptom for people with Hashimoto’s is fatigue and in many cases this is being caused by the same brain inflammation.
When these people perform activities that require mental activity, such as reading, studying or driving for long periods of time, they get tired.
Even after they start taking thyroid hormones, they may continue to have these symptoms.
Their brain has less endurance so they get tired when they use their brain for extended periods of time.
If you have fatigue when you read or study, drive or have long conversations, this is brain-based fatigue. You cannot get brain endurance back unless you support your brain. At this point it is not simply a thyroid hormone problem anymore.
The thing to realize is that this inflammation and subsequent fatigue may also be caused by an autoimmune response and that things that trigger your immune system may be triggering your brain inflammation and degeneration.
Let’s take a look at a couple of the usual suspects. One is gluten, the other is leaky gut. Together they add up to leaky brain and brain inflammation.
A protein found in connection with gluten consumption called zonulin is linked to leaky gut ( intestinal permeability) —the very thing that commonly leads to antibody reactions to foods which leads to sensitivities, allergies and even (eventually) things like Hashimoto’s.
There is a direct link between inflammation in the gut (commonly generated by irritating things such as gluten), microglial activation (as a result of these foreign compounds getting into the bloodstream) and brain degeneration.
If you have leaky gut, you may also have leaky brain. These same proteins are found in the blood brain barrier. When they break down in the gut, they can also sometimes break down in the brain.
This is often why people’s brain fog doesn’t improve with thyroid hormone. In order to improve brain fog, you must reduce brain inflammation and heal the barrier systems because when things enter the brain that shouldn’t the microglia respond and if that response is severe the tissue around it can be collateral damage.
The microglial cells also make up the blood-brain barrier, a thin barrier that lines the brain and only allows tiny, necessary substances to pass through.
The blood-brain barrier is important for keeping the bad guys (foreign invaders, such as viruses or bacteria) and environmental toxins out of the brain.
Unfortunately, according to Dr. Datis Kharrazian, (author of the new book, Why Isn’t My Brain Working?: A Revolutionary Understanding of Brain Decline and Effective Strategies to Recover Your Brain’s Health ) the blood-brain barrier can develop “leaks” for a variety of reasons.
These include poor blood-sugar stability (particularly insulin resistance), chronic stress, chronic inflammation, poor gut health, poor diet with unhealthy fats, and unchecked autoimmune activity, such as Hashimoto’s disease (alcohol and high homocysteine are also recognized factors).
Autoimmune attack on parts of the brain have been noted with Hashimoto’s patients. One part of the brain that has been observed to be vulnerable in these patients is the cerebellum.
And as it turns out, research has also shown that gluten can lead to destruction of the cerebellum. Coincidence? We think not.
We have discussed the immune system in the brain above, well, another thing that’s important to understand is that it has no “off switch”.
If there is an immune response in the brain there is nothing to call off the attack, then the microglial cells create brain inflammation and chew up brain tissue in the process.
One of the things that I frequently discuss in my content and in my consultations is that Hashimoto’s is a multi-system disorder. It’s not just a thyroid problem or just an immune system problem.
It extends into all the major systems of the body including the liver, the adrenals, the pancreas, the stomach, the digestive tract and, yes, the brain.
And this is often why people don’t get better. Their doctors ignore all these other systems that are breaking down and just keep increasing the dosage of their thyroid hormone.
Well, a lot of times that just doesn’t work. You need to have a multi-system strategy.
That’s what I offer in my work with patients. A strategy for first determining where the problems are and then a program designed to fix them.
You have to start by addressing the areas that helped cause a leaky blood-brain barrier if you want to restore brain integrity.
First make sure your diet is 100% gluten free. Then we get you on the Hashimoto’s diet, to determine whether other foods, such as dairy or eggs, are also provoking the immune system.
Then we work on the other systems that are involved. For example, balancing blood sugar, addressing gut health and gut infections, and supporting adrenal health so your adrenal hormones are neither too high or too low.
All of these will help put out the fires of inflammation, the killer of brain cells.
In addition, we use supplements created specifically for blood-brain barrier integrity, brain inflammation and increased blood flow to the brain.
And we may also work on other strategies like enhancing the liver’s detoxification pathways and supplementing with alpha-lipoic acid.
Would you like to know if a brain workup would make sense for you?
Click the link in the right column of the home page and schedule a free 30 minute Hashimoto’s Healing Discovery session and we will talk about how my program can help save your brain.
I look forward to speaking with you – unless you forget about it because of your brain fog…… 😉
http://www.nature.com/mp/journal/v7/n1/full/4000988a.html – thyroid hormone in the CNS
http://www.jneurosci.org/content/21/6/2028.full.pdf – thyroid hormone and microglial development
http://sanjosefuncmed.com/thyroid-brain-crosstalk-part-1-microglia-neuron-thyroid-connection/ – Dr. Kharrazian Brain Thyroid crosstalk
http://www.ff.ul.pt/FCT/PTDC/NEU-NMC/0381/2012/29.pdf – microglia in the developing brain
http://www.ncbi.nlm.nih.gov/pubmed/18591119 – thyroid autoimmunity and Parkinson’s disease
http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/thyroid/thyroid_preg.html – thryoid, pregnancy and fetal development
http://www.ncbi.nlm.nih.gov/pubmed/11837499 – thyroid hormone and fetal development
http://www.ncbi.nlm.nih.gov/pubmed/21212091 – thryoid hormone and fetal neurological development
http://www.sciencedaily.com/releases/2013/08/130813111730.htm – autism and hypothyroidism
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1789.2009.01042.x/abstract;jsessionid=3BA4CE033A73D859A26C3A238C8D2947.f02t02? – gluten and brain degeneration
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241183/ – thyroid hormone deficiency and environmental toxins
http://hypothyroidmom.com/maternal-hypothyroidism-and-fetal-brain-development/ – self explanatory
http://www.thyroidmanager.org/chapter/thyroid-hormones-in-brain-development-and-function/ – very detailed look at thyroid hormone and the brain
Ganguli M, Burmeister LA, Seaberg EC, Belle S, DeKosky ST. Association between dementia and elevated TSH: a community-based study. Biol. Psychiatr. 1996; 40: 714-725.
http://www.ncbi.nlm.nih.gov/pubmed/18990131 – Hashimoto’s Encepholopathy
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0055758 – Cognitive Impairments in Hashimoto’s Encephalopathy: A Case-Control Study
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1737486/ – ataxia and Hashimoto’s
http://thyroidbook.com/blog/hashimotos-hypothyroidism-and-how-to-protect-your-brain/ -Dr. K breaks it down